Most Relevant Information
Provider Data
| NPI Number: | 1003264565 |
| Provider Name: | ALYSON TERESE DETIG BCBA |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | 11521250 |
Most Important Dates
| Enumeration Date: | 05/25/2016 |
| Last Updated: | 05/25/2016 |
Provider Practice Location
1071 VALLEY RD
STIRLING
NJ
079801523
Practice Location Phone/Fax
| Phone: | 9066046500 |
| Fax: |
Provider Mailing Location
35 WALTON AVE
NEW PROVIDENCE
NJ
079741745
Provider Mailing Phone/Fax
| Phone: | 9087236380 |
| Fax: |